A number of innovative drugs are due to enter clinical trials and a daily
drink, which is not a drug, is thought to reduce damage to neurone membranes

For the hundreds of thousands of dementia sufferers in Britain and their families, the future can look very bleak. Despite intense research, a cure remains elusive. There hasn’t been a new treatment on the market for 10 years. But the good news is that 2013 could be a turning point, with a number of innovative drugs due to enter clinical trials.

Some doctors believe that the new medications offer, if not a cure, then at least a means of alleviating symptoms and slowing the progression of the disease.

At present, there is one group of medications that are routinely given to those with Alzheimer’s, the most common cause of dementia. They are called cholinesterase inhibitors, and work by slowing the breakdown of a crucial neurotransmitter in the brain called acetylcholine. Nerve cells (neurones) communicate with each other via acetylcholine production, which is reduced in Alzheimer’s patients.

The main drug in this category, donepezil (brand name Aricept), made headlines a few years ago because although dosage costs only around £2.50 a day, the government decided to restrict its use, stating that it was too expensive for the majority of sufferers. Since then, it has come off patent and the cost to the NHS has plummeted, so it is far more widely prescribed. Even so, Aricept does not work for everyone. In those it does work for, it only offers benefit for a maximum of about a year before it stops working and the sufferer deteriorates to the level of functioning they would have been at anyway.

Another drug currently in use is memantine (Ebixa). This works by reducing the amount of glutamate in the brain, a chemical that is thought to contribute to the symptoms and progression of Alzheimer’s. At present, this remains prohibitively expensive and many NHS trusts are reluctant to pay for it, restricting its use to those with late stage dementia and for whom all else has failed. It is often used to manage severe behavioural problems and agitation. However, many doctors feel that its real benefit is to those in the early stages of the disease, when small improvements allow sufferers to remain independent for longer.

Recent research has focused on two pathological changes that take place in the brains of Alzheimer’s sufferers. The first is the deposition of amyloid plaques – lumps of protein that form in neurones and stop them working properly. The second is the build-up of “neurofibrillary tangles” caused by another abnormal protein, the tau protein. Drugs have been developed that target these two proteins and break down or prevent their formation. Initial results look promising.

Dr Laura Phipps, of Alzheimer’s Research UK, explains: “Several potential new treatments for Alzheimer’s will enter late-stage clinical testing this year. These include a phase two and a phase three trial with drugs aimed at blocking the build-up of amyloid. A drug designed to stop the toxic clumping of tau protein will also enter phase three clinical testing in people with Alzheimer’s and fronto-temporal dementia.” She warns that it will be years before we know whether any of these treatments are successful.

Another product, due to be launched at the end of this month, is said to improve the memory of those with Alzheimer’s but is not a tablet and doesn’t require a prescription. Scientists at Massachusetts Institute of Technology (MIT) have spent 15 years developing a once-daily drink that, they claim, helps the body maintain synapses – the connections between neurones, which are gradually lost in Alzheimer’s.

The rationale behind the drink, called Souvenaid, is that the amyloid causes damage to the neurone membranes, which results in the loss of synapses and symptoms of poor memory. The scientists – led by Richard Wurtman, professor of neuroscience and neuropharmacology at MIT – reasoned that if the body was able to repair the damage done to the membranes, this might help the symptoms. They realised that for this to happen, the brain would need higher concentrations of the building blocks, such as fatty acids, antioxidants and vitamins, required to make new membranes. They examined metabolic pathways used by the body to make neurone membranes and developed a drink that included them in concentrations far higher than are found in a regular diet.

Tests using cultured cells were encouraging. The drink is not a drug, but a “food for medical purposes”, and its sale is regulated by the Food Standards Agency. This means it hasn’t gone through the same rigorous efficacy testing as medicines do. Yet there have been several double-blind, placebo-controlled trials undertaken, and the results were encouraging.

The first trial ran for 12 weeks and had 225 participants; the second ran for 24 weeks with 259 people involved. On tests of memory, those consuming 125ml of Souvenaid each day for 12 weeks showed statistically significant better scores compared with those taking the placebo; this improvement continued through to 24 weeks. Patients in an extension study that ran for a further 24 weeks continued to show improvement. Participants who had been receiving a placebo and were switched to receive Souvenaid also showed improvement in their memory. The drink had virtually no side-effects. The results were reported at the Alzheimer’s Association International Conference in Vancouver, Canada, last summer.

While the initial studies were funded by the manufacturer – the yogurt company Danone – the EU has now funded further, independent studies into Souvenaid, and it will be available to purchase from pharmacists. However, patients will need to be assessed by a doctor first, and given a recommendation slip. This is not a cure for Alzheimer’s. But many doctors see it as an opportunity for sufferers to feel more in control of their condition.

However, while the research appears positive, Clive Ballard, director of research at the Alzheimer’s Society and professor of old age psychiatry at King’s College London, advises caution: “People shouldn’t get excited that an off-the-shelf drink is going to transform the lives of people with dementia. While it showed some memory benefits, there’s no evidence it has any effect on other symptoms such as activities of daily living.”

As is so often the case, cost comes into it. The drink will, for the time being, be entirely self-funded; it is not available on NHS prescription. The price has not been confirmed but it is likely to be around £3 a day – a significant sum when added up over the year. And you need to keep taking it to get any benefit. “People would be better off putting the money they would spend on this drink towards gym membership or a few games of tennis,” says Prof Ballard. “Regular exercise is a far more effective way of reducing cognitive decline.” But certainly for those who can afford it, Souvenaid offers another option to be considered.

Research is also being undertaken into drugs used to treat other conditions, but which might help in dementia, too. Prof Ballard has already shown that drugs as common as paracetamol can be effective in treating agitation and distress in those with dementia. Trials are ongoing on other medications, ranging from those used in the treatment of high blood pressure and diabetes, to statins and even some antibiotics.

For the first time in years, there appears to be a sense of hope, agrees Dr Phipps. “We enter 2013 with a feeling of optimism, that with continued support, we will make more breakthroughs in understanding dementia and the diseases that cause it.”

Thanks to tireless research and determination from scientists around the world, there does appear to be the faintest chink of light for those with this dark and dreadful condition.

Max Pemberton’s latest book, 'The Doctor Will See You Now’ (Hodder), is available through Telegraph Books; call 0844 871 1515 or visit books.telegraph.co.uk